McCall McPherson argues that standard testosterone reference ranges for women are too low and that treatment can improve vitality and exercise capacity. She recommends target ranges of 35-65 and favors rapid-dissolve sublingual tablets over topical creams for faster absorption and fewer side effects like unwanted hair growth.
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If you're post, even premenopausal or postmenopausal, the ranges for, quote, optimal testosterone on many labs go down to, like, zero for women. So they're like, well, we don't want you to have too much, but we really don't care at all if you don't have any. So that's a problem. Like, testosterone really improves our quality of life, our vitality, our longevity, our ability to exercise effectively. So what a shame. They're very concerned about it for men, but not at all for women. So, again, optimal ranges are 35 to 65 when we treat with testosterone. Let's talk about multiple options. My preferred option is to do what's called a ready dissolvable tablet. I have my own right here. If you're watching the video and they are just, you open this, there's a little dissolvable tablet that you pop under your tongue. I literally took one 10 minutes ago. Let it dissolve in your oral mucosa as long as it can and absorbs through that oral mucosal lining. And the reason I like these, what's called RDT tablets, it gets in your system really quickly. It does not like a cream that has to build up over weeks and weeks. You can time it flexibly during the day. You don't have to do a cream twice a day. You don't have to worry about exposing your children to it. Right? So it's just sort of more convenient. The biggest one, though, is an advantage over testosterone cream. So testosterone cream was the way that I used to do it for many, many years. The downside of cream, y', all is it does. It takes a long time to integrate into your system. But in addition to that, for women especially, usually you place testosterone cream, like, on your inner thighs. When you do that, you're going to grow more hair locally where you are placing your testosterone cream, okay. And it's usually dark, it's usually a little bit black. And you know what, most women don't want that. And it doesn't necessarily stop growing. If you stop using testosterone cream, sometimes it sticks with you and you end up having to do laser hair removal, et cetera. So that's a bummer. And because of that, I switched to dissolvable tablets years ago. The one downside of dissolvable tablets compared to cream is I feel that they're easier to mess up. From a compounding perspective, I feel like there's a little more built in compounding error in terms of dosing. It either leaves people a little high or a little low, and it's just harder to really hit the nail on the head. But pros versus cons, I still think it's worth it. When we treat people with dissolvable tablets, we always, always follow up with labs and, of course, discuss symptoms.
